Department of Ophthalmology, University of Würzburg, Würzburg, Bavaria, 97080, Germany.
F1000Res. 2020 Oct 15;9:1245. doi: 10.12688/f1000research.26772.2. eCollection 2020.
To compare two-year results of a filtering trabeculotomy (FTO) to conventional trabeculectomy (TE) in open-angle glaucoma by exact matching. 110 patients received an FTO and 86 a TE. FTO avoided the need for an iridectomy due to a preserved trabeculo-descemet window anterior to the scleral flap. TE employed a trabecular block excision and iridectomy. Mitomycin C was used in both. FTO and TE were exact matched by baseline intraocular pressure (IOP) and the number of glaucoma medications. Complete and qualified success (IOP ≤18 mmHg and IOP reduction ≥ 30%, with or without medication) were primary endpoints. IOP, visual acuity (BCVA), complications and intervention were secondary endpoints. 44 FTO were exact matched to 44 TE. The IOP baseline in both groups was 22.5±4.7 mmHg on 3±0.9 medications. At 24 months, complete success was reached by 59% in FTO and 66% in TE, and qualified success by 59% in FTO and 71% in TE. In FTO, IOP was reduced to 12.4±4.3 mmHg at 12 months and 13.1±4.1 mmHg at 24 months. In TE, IOP was 11.3±2.2 mmHg at 12 months and 12.0±3.5 mmHg at 24 months. Medications could be reduced at 24 months to 0.6±1.3 in FTO and 0.2±0.5 in TE. There were no significant differences between the two groups in IOP, medications, complications or interventions at any point. Modifying aqueous flow through a limited trabeculotomy in FTO yielded clinical outcomes similar to traditional TE but allowed to avoid an iridectomy.
通过精确匹配比较 110 例滤过性小梁切开术（FTO）和 86 例传统小梁切除术（TE）治疗开角型青光眼的两年结果。FTO 避免了因在巩膜瓣前保留小梁 - 内皮窗而需要进行虹膜切除术。TE 采用小梁块切除和虹膜切除术。两者均使用丝裂霉素 C。FTO 和 TE 通过基础眼压（IOP）和青光眼药物数量进行精确匹配。完全和合格的成功（IOP≤18mmHg 和 IOP 降低≥30%，有或无药物）是主要终点。眼压、视力（BCVA）、并发症和干预是次要终点。44 例 FTO 与 44 例 TE 精确匹配。两组的基础眼压在 24 个月时分别为 22.5±4.7mmHg 和 3±0.9 种药物。在 24 个月时，FTO 的完全成功率为 59%，TE 为 66%，FTO 的合格成功率为 59%，TE 为 71%。在 FTO 中，IOP 在 12 个月时降至 12.4±4.3mmHg，在 24 个月时降至 13.1±4.1mmHg。在 TE 中，IOP 在 12 个月时为 11.3±2.2mmHg，在 24 个月时为 12.0±3.5mmHg。在 24 个月时，FTO 的药物可减少至 0.6±1.3，TE 减少至 0.2±0.5。两组在任何时间点的眼压、药物、并发症或干预措施均无显著差异。FTO 通过有限的小梁切开术改变房水流量，产生与传统 TE 相似的临床结果，但可以避免虹膜切除术。
